1. What are the major issues in this case? What should Elizabeth Ryan do?

The major issues of the case are employee dissatisfaction, hygiene, employee conflict, poor management, interpersonal relations and customer dissatisfaction. It can be clearly seen from the major issues why this particular clinic is not doing well. Elizabeth Ryan needs to change and organize the clinic operations. The management structure is not well defined, the first thing Elizabeth Ryan in management change should do is to define and properly state the formal chain of command between different levels of authority, for example based on experience the senior and junior technicians role can be established. She needs to revamp the clinic’s marketing strategies and start advertising its services. Running a brand solely on word to mouth marketing is not effective as well as efficient. One of the difficult responsibility she needs to deal with is her problem employee Moore, which is leading to productivity issue, morale problems, poor quality of treatment and customer dissatisfaction, which is turning out to be the most pressing issue of all and it is also clear that it will be impossible to go ahead with other changes until this one is dealt with. Elizabeth Ryan will have to raise her employee Gulford’s morale, as she is the one who is handling all the heavy workload. By resolving the employee conflict above, she can improve the work environment and raise the clinic’s performance and ultimately customer satisfaction.

2. Assuming that Elizabeth Ryan decides to speak with Gretchen Moore, how should Ryan prepare for the meeting with Gretchen Moore?

It is not an easy task to initiate difficult conversations and feedback with employees. Given Elizabeth Ryan’s background, she seems to have more experience working with men. Body odor problem is a very delicate and sensitive issue and she needs